April 2003, Galway
Over sixty psychologists from learning disability services gathered in Galway for the annual workshop of the PSI Learning Disability Group. The delegates traveled from the four corners of Ireland to hear an excellent range of presentations of interest to practitioners in learning disability services. The workshop theme, ‘Controversies in learning disability practice’, was chosen to reflect the complexities and challenges for practitioners in their working lives. Presentation topics included legal aspects of clinical practice, the issue of consent among service users, sexuality, the new Mental Health Act, and developments in the training of clinical psychologists.
Opening the workshop with one of two keynote presentations was Teresa Blake, a Dublin-based barrister with a long involvement in disability law. Teresa gave an excellent, thought-provoking talk on the legal issues involved in working with children and their families. This was followed by an equally stimulating presentation by Galway disability law consultant, Christina Burke, who gave a distillation of her recent research into the legal complexities of informed consent—a topic on which she had reported for NAMHI. The resounding message from both the legal presenters was that while we still have an unsatisfactory legal framework for the delivery of learning disability services, there is a reassuring hint of signs of change in the areas of legal controversy and a gradual move towards rights-based legislation.
The legal overview set the scene for two papers on sexuality in people with learning disability. David Evans, a researcher with the Western Health Board Department of Public Health, presented the findings of a survey on relationships and sexuality conducted among service users, staff and parents in the Galway Association. Using a focus group method to learn the views of service users, David highlighted the discrepancy between the normal aspirations of service users for both intimate and non-sexual relationships and the generally more conservative views of parents, with staff views tending to fall somewhere between the other two groups. Clinical psychologist Brian McGuire of the Galway Association then discussed the specific complexities of assessing capacity to participate in sexual relationships. This paper highlighted the problem of service users who may understand some aspects of sexuality, but not others, as well as problems that arise when adult service users have the capacity for a sexual relationship, but their primary caregiver raises objections.
Brian McGuire also presented a joint paper with Michael Reen, clinical psychologist with the Brothers of Charity services in Ennis, which explored the implications for practitioners and service users of the new Mental Health Act, highlighting particularly the fact that the definition of mental disorder may apply to people with a learning disability and challenging behaviour, who may not necessarily have a psychiatric disorder.
The final presentation, by Jack James from NUI Galway, provided an overview of the urgent national need for greater numbers of trained clinical psychologists. The Easter Workshop, always a highlight in the year for psychologists in learning disability services, was a hugely stimulating and successful meeting.